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Development and Validation of a Novel At-home Smell Assessment.
Gupta, Shruti; Kallogjeri, Dorina; Farrell, Nyssa F; Lee, Jake J; Smith, Harrison J; Khan, Amish M; Piccirillo, Jay F.
  • Gupta S; Medical College of Georgia, Augusta.
  • Kallogjeri D; Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.
  • Farrell NF; Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.
  • Lee JJ; Statistical Editor, JAMA Otolaryngology-Head & Neck Surgery.
  • Smith HJ; Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.
  • Khan AM; Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.
  • Piccirillo JF; Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.
JAMA Otolaryngol Head Neck Surg ; 148(3): 252-258, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1620083
ABSTRACT
IMPORTANCE Current tools for diagnosis of olfactory dysfunction (OD) are costly, time-consuming, and often require clinician administration.

OBJECTIVE:

To develop and validate a simple screening assessment for OD using common household items. DESIGN, SETTING, AND

PARTICIPANTS:

This fully virtual diagnostic study included adults with self-reported OD from any cause throughout the US. Data were collected from December 2020 to April 2021 and analyzed from May 2021 to July 2021. MAIN OUTCOMES AND

MEASURES:

Participants with self-reported olfactory dysfunction took a survey assessing smell perception of 45 household items and completed the Clinical Global Impression-Severity (CGI-S) smell questionnaire, the University of Pennsylvania Smell Identification Test (UPSIT), and the 36-item Short Form Survey (SF-36). Psychometric and clinimetric analyses were used to consolidate 45 household items into 2 short Novel Anosmia Screening at Leisure (NASAL) assessments, NASAL-7 (range, 0-14; lower score indicating greater anosmia) and NASAL-3 (range, 0-6; lower score indicating greater anosmia).

RESULTS:

A total of 115 participants were included in the study, with a median (range) age of 42 (19-70) years, 92 (80%) women, and 97 (84%) White individuals. There was a moderate correlation between the UPSIT and NASAL-7 scores and NASAL-3 scores (NASAL-7 ρ = 0.484; NASAL-3 ρ = 0.404). Both NASAL-7 and NASAL-3 had moderate accuracy in identifying participants with anosmia as defined by UPSIT (NASAL-7 area under the receiver operating curve [AUC], 0.706; 95% CI, 0.551-0.862; NASAL-3 AUC, 0.658; 95% CI, 0.503-0.814). Scoring 7 or less on the NASAL-7 had 70% (95% CI, 48%-86%) sensitivity and 53% (95% CI, 43%-63%) specificity in discriminating participants with anosmia from participants without. Scoring 2 or less on the NASAL-3 had 57% (95% CI, 36%-76%) sensitivity and 78% (95% CI, 69%-85%) specificity in discriminating participants with anosmia from participants without. There was moderate agreement between UPSIT-defined OD categories and those defined by NASAL-7 (weighted κ = 0.496; 95% CI, 0.343-0.649) and those defined by NASAL-3 (weighted κ = 0.365; 95% CI, 0.187-0.543). The agreement with self-reported severity of olfactory dysfunction as measured by CGI-S and the NASAL-7 and NASAL-3 was moderate, with a weighted κ of 0.590 (95% CI, 0.474-0.707) for the NASAL-7 and 0.597 (95% CI, 0.481-0.712) for the NASAL-3. CONCLUSION AND RELEVANCE The findings of this diagnostic study suggest that NASAL-7 and NASAL-3, inexpensive and brief patient-reported assessments, can be used to identify individuals with OD. As the burden of COVID-19-associated OD increases, these assessments may prove beneficial as screening and diagnostic tools. Future work will explore whether the NASAL assessments are sensitive to change and how much of a change is clinically important.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Olfaction Disorders Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: JAMA Otolaryngol Head Neck Surg Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Olfaction Disorders Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: JAMA Otolaryngol Head Neck Surg Year: 2022 Document Type: Article